Abstract
First described by Klemperer and Rabin in 1931, solitary fibrous tumour of the pleura (SFTP) is a mesenchymal tumour that tends to involve the pleura, although it has also been described in other thoracic areas (mediastinum, pericardium and pulmonary parenchyma) and in extrathoracic sites (meninges, epiglottis, salivary glands, thyroid, kidneys and breast). SFTP usually presents as a peripheral mass abutting the pleural surface, to which it is attached by a broad base or, more frequently, by a pedicle that allows it to be mobile within the pleural cavity. A precise preoperative diagnosis can be arrived at with a cutting-needle biopsy, although most cases are diagnosed with postoperative histology and immunohistochemical analysis of the dissected sample. SFTP, owing to its large size or unusual locations (paraspinal, paramediastinal, intrafissural and intraparenchymal), can pose interpretation problems or, indeed, point towards a diagnosis of diseases of a totally different nature. We present some unusual radiographic and computed tomography (CT) images of large SFTP or SFTP located in atypical thoracic locations in patients who underwent surgical resection.
Riassunto
Il tumore fibroso solitario della pleura (TFSP), descritto per la prima volta da Klemperer e Rabin nel 1931, é una neoplasia mesenchimale che solitamente coinvolge la pleura, ma che viene descritta anche in altre sedi sia toraciche, quali il mediastino, il pericardio ed il parenchima polmonare, sia extratoraciche, quali le meningi, l’epiglottide, le ghiandole salivari, la tiroide, i reni e la mammella. Di solito si presenta come massa periferica a contatto con la superficie pleurica alla quale è unito da una larga base d’impianto o più spesso da un peduncolo che lo puè rendere mobile all’interno del cavo pleurico. La diagnosi preoperatoria di certezza puè essere ottenuta mediante biopsia con ago tranciante, ma nella maggior parte dei casi è post-chirurgica, frutto dell’esame istologico e dell’analisi immuno-istochimica sul pezzo operatorio. Il tumore fibroso solitario della pleura tuttavia, spesso a causa delle notevoli dimensioni o dello sviluppo in sedi inconsuete (paraspinali, paramediastiniche, intrascissurali ed intraparenchimali) può creare numerose difficoltà di interpretazione o addirittura orientare la diagnosi verso patologie di tutt’altra natura. In questo lavoro presentiamo gli aspetti radiologici inusuali di TFSP di grosse dimensioni o localizzati in sedi toraciche atipiche in pazienti sottoposti ad intervento chirurgico di exeresi.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References/Bibliografia
Hanau CA, Miettinen M (1995) Solitary fibrous tumor: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites. Hum Pathol 26:440–449
de Perrot M, Fischer S, Bründler MA et al (2002) Solitary fibrous tumors of the pleura. Ann Thorac Surg 74:285–293
Ferretti GR, Chiles C, Choplin RH, Coulomb M (1997) Localized benign fibrous tumors of the pleura. AJR Am J Roentgenol 169:683–686
Rosado-de-Christenson ML, Abbott GF, McAdams HP et al (2003) Localized fibrous tumors of the pleura. Radiographics 23:759–783
Tagliabue F, Vertemati G, Confalonieri G et al (2005) Benign solitary fibrous tumour of the pleura: a clinical review and report of six cases. Chirurgia Italiana 57:649–653
Briselli M, Mark EJ, Dickersin R (1981) Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer 47:2678–2689
Bongiovanni M, Viberti L, Pecchioni C et al (2002) Steroid hormone receptor in pleural solitary fibrous tumors and cd34+ progenitor stromal cells. J Pathol 198:252–257
England DM, Hochholzer L, McCarthy MJ (1989) Localized benign and malignant fibrous tumors of the pleura. Am J Surg Pathol 13:640–658
Suter M, Gebhard S, Boumghar M et al (1998) Localized fibrous tumours of the pleura: 15 new cases and review of the literature. Eur J Cardiothorac Surg 14:453–459
Tafltepe I, Alper A, Özaydin HE et al (2000) A case of multiple synchronous localized fibrous tumor of the pleura. Eur J Cardiothorac Surg 18:491–494
Yousem SA, Flynn SD (1988) Intrapulmonary localized fibrous tumor. Am J Clin Pathol 89:365–369
Aufiero TX, McGary SA, Campbell DB, Phillips PP (1995) Intrapulmonary benign fibrous tumor of the pleura. J Thorac Cardiovasc Surg 110:549–551
Weiss B, Horton D (2002) Preoperative embolization of a massive solitary fibrous tumor of the pleura. Ann Thorac Surg 73:983–985
Robinson LA, Reilly RB (1994) Localized pleural mesothelioma. The clinical spectrum. Chest 106:1611–1615
Ali SZ, Hoon V, Hoda S et al (1997) Solitary fibrous tumor. A cytologichistologic study with clinical, radiologic, and immunohistochemical correlations. Cancer Cytopathol 81:116–121
Tateishi U, Nishihara H, Morikawa T, Miyasaka K (2002) Solitary fibrous tumor of the pleura: MR appearance and enhancement pattern. J Comput Assist Tomogr 26:174–179
Clayton AC, Salomão DR, Keeney GL, Nascimento AG (2001) Solitary fibrous tumor: a study of cytologic features of six cases diagnosed by fine-needle aspiration. Diagn Cytopathol 25:172–176
Gold JS, Antonescu CR, Hajdu C et al (2002) Clinicopathologic correlates of solitary fibrous tumors. Cancer 94:1057–1068
Vallat-Decouvelaere AV, Dry S, Fletcher C (1998) Atypical and malignant solitary fibrous tumors in extrathoracic locations: evidence of their comparability to intra-thoracic tumors. Am J Surg Pathol 22:1501–1511
Moran CA, Suster S, Koss MN (1992) The spectrum of histologic growth patterns in benign and malignant fibrous tumours of the pleura. Semin Diagn Pathol 9:169–180
Scharifker D, Kaneko M (1979) Localized fibrous “mesothelioma” of pleura (submesothelial fibroma). Cancer 43:627–635
Krismann M, Adams H, Jaworska M et al (2000) Patterns of chromosomal imbalances in benign solitary fibrous tumours of the pleura. Virchows Arch 437:248–255
Van de Rijn M, Lombard CM, Rouse RV (1994) Expression of CD34 by solitary fibrous tumors of the pleura, mediastinum and lung. Am J Surg Pathol 18:814–820
Miettinen M, Lindenmayer AE, Chaubal A (1994) Endothelial call markers CD31, CD34 and BNH9 antibody to H- and Y-antigens: evaluations of their specificity and sensitivity in the diagnosis of vascular tumors and comparisons with Von Willebrand factor. Mod Pathol 7:82–90
Dedrick CG, McLoud TC, Shepard JAO, Shipley RT (1985) Computed tomography of localized pleural mesothelioma. AJR Am J Roentgenol 144:275–280
Okike N, Bernatz PE, Woolner LB (1978) Localized mesothelioma of the pleura. beningn and malignant variants. J Thorac Cardiovasc Surg 75:363–372
Saifuddin A, Da Costa P, Chalmers AG et al (1992) Primary malignant localized fibrous tumours of the pleura: clinical, radiological, and pathological features. Clin Radiol 45:13–17
Truong M, Munden RF, Kemp BL (2000) Localized fibrous tumor of the pleura. AJR Am J Roentgenol 174:42
Biçer M, Yaldiz S, Gürsoy S, Ülan M (1998) A case of giant benign localized fibrous tumor of the pleura. Eur J Cardiothorac Surg 14:211–213
Oliaro A, Filosso PL, Casadio C et al (1994) Il mesotelioma fibroso benigno della pleura. Minerva Chir 49:1311–1316
Kim JH, Kim JO, Kim SY et al (2001) Two cases of large solitary fibrous tumors of the pleura associated with fasting hypoglycemia. Eur Radiol 11:819–824
Ulrik CS, Viskum K (1998) Fibrous pleural tumour producing 171 litres of transudate. Eur Respir J 12:1230–1232
Theros EG, Feigin DS (1977) Pleural tumors and pulmonary tumors: differential diagnosis. Semin Roentgenol 12:239–247
Martens B, Bonnet P, Duquesne L (1995) Solitary fibrous tumor pleura. Acta Chir Belg 95:127–129
Dynes MC, White EM, Fry WA, Ghabremani GG (1992) Imaging manifestations of pleural tumors. Radiographics 12:1191–1201
Kucuksu N, Thomas W, Ezdinli EZ (1976) Chemotherapy of malignant diffuse mesothelioma. Cancer 37:1265–1274
Lee KS, Im JG, Choe KO et al (1992) CT findings in benign fibrous mesothelioma of the pleura. Pathological correlation in nine patients. AJR Am J Roentgenol 158:983–986
de Perrot M, Kurt AM, Robert JH et al (1999) Clinical behavior of solitary fibrous tumors of the pleura. An Thorac Surg 67:1456–1459
Mendelson DS, Meary E, Buy JN et al (1991) Localized fibrous pleural mesothelioma: CT findings. Clinical Imaging 15:105–108
Rubenstein WA, Gray G, Auh YH (1986) CT of fibrous tissues and tumors with sonographic correlations. AJR Am J Roentgenol 147:1067–1074
Rena O, Filosso PL, Papalia E et al (2001) Solitary fibrous tumour of the pleura: surgical treatment. Eur J Cardiothorac Surg 19:185–189
Robinson LA (2006) Solitary fibrous tumor of the pleura. Cancer Control 13:264–269
Cardinale L, Allasia M, Ardissone F et al (2006) CT features of solitary fibrous tumour of the pleura: experience in 26 patients. Radiol Med 111:640–650
Cardinale L, Solitro F, Fava C (2005) Inverted solitary fibrous tumor of the pleura mimicking a pulmonary mass. JBR-BTR 88:342
Patsios D, Hwang DM, Chung TB (2006) Intraparenchymal solitary fibrous tumor of the lung: an uncommon cause of a pulmonary nodule. J Thorac Imaging 21:50–53
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cardinale, L., Cortese, G., Familiari, U. et al. Fibrous tumour of the pleura (SFTP): a proteiform disease. Clinical, histological and atypical radiological patterns selected among our cases. Radiol med 114, 204–215 (2009). https://doi.org/10.1007/s11547-008-0345-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11547-008-0345-7